Identification and Management of Perinatal Depression: Differences between Healthcare Providers

Objective: Pilot data was collected to examine providers’ beliefs, knowledge, self-efficacy, barriers, and practices related to perinatal depression and how they may differ across provider types. Background: High prevalence and detrimental impact of depression during pregnancy and the first year postpartum (i.e. perinatal period) on maternal and child health outcomes highlights the need for improving diagnosis and treatment during this critical period. Healthcare providers play a significant role in helping to identify and manage perinatal depression. Methods: Ninety-nine providers (e.g. physicians, nurses, mental health workers, public health practitioners) who provide care to pregnant women in Colorado completed a 64-item online survey. Results: Although 94% of providers reported it was their responsibility to recognize perinatal depression, variations across specialties with regards to responsibility to treat were found. Most providers (91%) reported use of a screening tool for depression, 60% of providers provide counseling on perinatal depression, and 80% of providers refer patients for treatment of perinatal depression on at least a monthly basis. Significant differences in knowledge, self-efficacy, current practices, and perceived patient barriers were found across provider specialties. Conclusion: These findings highlight the need for expansion of online training programs to increase awareness of mental health resources in the community, improve confidence related to diagnosis and treatment of perinatal mood disorders, and to enhance communication between mental health specialists and healthcare providers in order to effectively identify and manage maternal depression.

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The Coronavirus Disease 2019 Pandemic in Taiwan: An Facebook Online study on Concern/Fear Regarding the Disease and General Anxiety and Relevant Factors (Preprint)

10.2196/preprints.21165 ◽

2020 ◽

Author(s):

Peng-Wei Wang ◽

Wei-Hsin Lu ◽

Yi-Lung Chen ◽

Dian-Jeng Li ◽

Yu-Ping Chang ◽

...

Keyword(s):

Mental Health ◽

Environmental Factors ◽

Online Survey ◽

Psychological Impact ◽

Health Resources ◽

World Health ◽

Regional Government ◽

General Anxiety ◽

Self Confidence ◽

Health Organization

BACKGROUND The World Health Organization (WHO) declared COVID-19 a ‘public health emergency of international concern. Both worry and anxiety are the common psychological impact during the pandemic. The level of and determinants for worry and anxiety during COVID-19 are not well explored. OBJECTIVE The present study aimed to explore the associations of demographic and environmental factors with worry toward COVID-19 and general anxiety among people in Taiwan. METHODS In total, 1970 respondents were recruited through a Facebook advertisement and completed an online survey on worry toward COVID-19, general anxiety during the pandemic, and individual and environmental factors. RESULTS In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was significantly associated with a higher level of worry toward COVID-19. Lower perceived social support was significantly associated with a higher level of general anxiety during the COVID-19 pandemic. CONCLUSIONS The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the disease outbreak. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. CLINICALTRIAL

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Military spouses with deployed partners are at greater risk of poor perinatal mental health: a scoping review

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2018-001069 ◽

2019 ◽

Vol 165 (5) ◽

pp. 363-370 ◽

Cited By ~ 1

Author(s):

Lauren Rose Godier-McBard ◽

L Ibbitson ◽

C Hooks ◽

M Fossey

Keyword(s):

Mental Health ◽

Social Support ◽

Scoping Review ◽

Healthcare Providers ◽

Well Being ◽

Perinatal Period ◽

Poor Mental Health ◽

Adverse Outcomes ◽

Military Spouses ◽

Perinatal Mental Health

BackgroundPoor mental health in the perinatal period is associated with a number of adverse outcomes for the individual and the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems.MethodsA scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O’Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE.ResultsThirteen papers fulfilled the inclusion criteria, all from the USA, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support.ConclusionsUS literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.

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Using peer support to strengthen mental health during the COVID-19 pandemic: a review (Preprint)

10.2196/preprints.30585 ◽

2021 ◽

Author(s):

Rahul Suresh ◽

Armaghan Alam ◽

Zoe Karkossa

Keyword(s):

Mental Health ◽

Peer Support ◽

Health Anxiety ◽

Healthcare Providers ◽

Health Resources ◽

Post Traumatic Stress ◽

Social And Emotional ◽

Mental Health Resource ◽

Positive Effects ◽

Anxiety Depression

BACKGROUND The coronavirus (COVID-19) pandemic has had a significant impact on society’s overall mental health with a notable effect on healthcare providers. To manage this global crisis, governments have had to implement numerous measures such mandated lockdowns and physical distancing to minimize the risk of overloading healthcare systems. Altogether, these measures have contributed to higher levels of anxiety, depression, insomnia, post-traumatic stress disorder, and other metrics indicating worsening mental health. Unfortunately, the availability of crucial mental health resources and support remains scarce during this time as services attempt to transition to an effective online delivery model. Peer support, which is peer-to-peer provided social and emotional support, is an underutilized and effective mental health resource that is easily delivered/accessed in-person by members within a social distancing bubble, or virtually across different bubbles. OBJECTIVE This review aims to summarize the toll that this pandemic has had on society’s mental health as found in peer-reviewed literature from October 2019 to March 2021, as well as suggest the utility of peer support to address these needs. Lastly, we provide strategies to effectively deliver peer support so that members of the community can better support one another during these unprecedented times. METHODS References for this review were chosen through searches of PubMed, Web of Science, and Google Scholar for articles published between October 2019 and March 2021 that used the terms: “coronavirus”, “COVID-19”, “mental health”, “anxiety”, “depression”, “isolation”, “mental health resources”, “peer support”, “online mental health resources”, and “healthcare workers”. Articles resulting from these searches and relevant references cited in those articles were reviewed. Articles published in English, French and Italian were included. RESULTS As stated in peer-reviewed literature, this pandemic has ubiquitously worsened the mental health of populations across the world, which is further exacerbated by extended periods of lockdown. Peer support has been demonstrated to yield positive effects on the mental health of a wide variety of recipients, and it can be provided through numerous accessible mediums such as web/mobile applications, video-conferencing software, workshops, telephone services, and student programs. CONCLUSIONS The provision of peer support can be very beneficial for improving mental health during the COVID-19 pandemic and may be an effective tool should similar events arise in the future. CLINICALTRIAL N/A

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Perinatal depression screening using smartphone technology: Exploring uptake, engagement and future directions for the MGH Perinatal Depression Scale (MGHPDS)

PLoS ONE ◽

10.1371/journal.pone.0257065 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257065

Author(s):

Rachel Vanderkruik ◽

Edwin Raffi ◽

Marlene P. Freeman ◽

Rebecca Wales ◽

Lee Cohen

Keyword(s):

Mental Health ◽

Depressive Disorders ◽

Perinatal Depression ◽

Depression Scale ◽

Perinatal Period ◽

Health Impact ◽

Depression Score ◽

Future Research ◽

Cross Sectional ◽

Longitudinal Data Collection

Women may experience new-onset or worsening depressive disorders during pregnancy and the postpartum. If untreated, there may be detrimental consequences to the health and wellbeing of the woman and to her baby. There is a need for improved tools and approaches that can be easily and broadly implemented to effectively detect depression during the perinatal period. Early identification of depression during pregnancy is an important first step towards connecting women to treatment and preventing continued depression into the postpartum or beyond. This report provides preliminary findings from a pilot study of a digital screening app for perinatal depression expiring potential for app reach, engagement, and user demographics and mental health symptoms. With mainly passive recruitment efforts, we collected cross-sectional mental health data on over 700 women during the perinatal period, including women across over 30 countries. We report on mean depression scores among women during pregnancy and the postpartum as well as on constructs that are commonly comorbid with depression, including anxiety, sleep dysregulation, and perceived stress. Over half of the women during pregnancy and over 70% of women in the postpartum had a depression score indicative of clinical depression. Future research directions for this work and potential for public health impact are discussed, including longitudinal data collection and analyses of symptomology over time and embedding evidence-based digital therapeutics into the app as a means to increase access to mental health services.

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The Needs of Women Users of Mental Health Services and their Families

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.077 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S8-S9

Author(s):

M. Amering

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Interpersonal Violence ◽

Health Resources ◽

Perinatal Period ◽

Mental Health Stigma ◽

Persons With Disabilities ◽

Women And Girls ◽

Gender Specific

AimUnderstand the needs of women users of mental health services and their families and discuss consequences.MethodNon-systematic review of concepts and data regarding the needs of women users of mental health services and their families.Resultsnequity and inefficiency of mental health resources affect men and women all around the globe. Some important mental health needs as well as barriers to care are gender-specific. Women have specific needs in specific phases of life, e.g. the perinatal period, as well as specific risk factors, e.g. interpersonal violence and sexual abuse. Developments of women only services as well as the implementation of gender-specific approaches in routine care are underway and need to be evaluated, amended and expanded. Training as well as research requirements are numerous and urgent. Family carers are an essential mental health resource. A majority is female with significant unmet needs. Family advocacy in mental health is prominently supported by female activists as is the psychiatric user movement. Because of the cumulation and the interaction of gender-based and other forms of discrimination, legislations such as those following the UN-Convention on the rights of persons with disabilities include specific provisions for women and girls with psychosocial disabilities.ConclusionsMental health stigma and discrimination interact with gender inequality and the discrimination of women and girls to their mental health detriment. Clinical and scientific responsibilities in mental health essentially include gender-specific attention to the needs of women and girls and their families.Disclosure of interestThe author has not supplied his declaration of competing interest.

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Mental Health Triage Tools for Medically Cleared Disaster Survivors: An Evaluation by MRC Volunteers and Public Health Workers

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2012.49 ◽

2013 ◽

Vol 7 (1) ◽

pp. 20-28 ◽

Cited By ~ 3

Author(s):

Donald E. Brannen ◽

Robert Barcus ◽

Mark A. McDonnell ◽

Andrea Price ◽

Corey Alsept ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Health Workers ◽

Health Resources ◽

The Past ◽

Clinical Vignettes ◽

Interclass Correlation ◽

Disaster Survivors ◽

Public Health Workers ◽

Better Than

AbstractObjectivePsychological assessment after disasters determines which survivors are acutely distressed or medically compromised and what kind of assistance is needed (whether practical or psychological). A mental health triage tool can help direct more people to the appropriate type of help. The purpose of this study was to determine the effectiveness of the Fast Mental Health Triage Tool (FMHT) and the Alsept-Price Mental Health Scale (APMHS) among public health workers and Medical Reserve Corps (MRC) volunteers in conducting mental health triage. Both tools screen for ability to follow simple commands, chronic medical conditions, mental health conditions and services, occult injuries, and traumatic events in the past year. Both were designed for use in disasters where mental health resources are scarce and survivors are already medically triaged.MethodsVolunteers (n = 204) and workers (n = 66) were randomized into 3 groups, with 79 participating. Fifty-nine raters completed 20 each of 1180 mental health clinical vignettes of disaster survivors.ResultsThe survey presenting the vignettes was highly reliable at 0.771; the study model was parallel between baseline and treatment; and the interclass correlation among the raters was high at 0.852. Each rater triaged the same cases, but the rater was randomly assigned to use FMHT, APMHS, or no tool or scale. Between-subject effect for the tools used was significant (P = .039). The FMHT was significantly better than no tool in correct mental health triage, 67.3% to 51.5% (P = .028).ConclusionThe incorporation of a temporal component should be evaluated for potential inclusion in existing mental health triage systems. (Disaster Med Public Health Preparedness. 2013;7:20-28)

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‘Having a Quiet Word’: Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214253 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4253 ◽

Cited By ~ 5

Author(s):

Emma Carlin ◽

David Atkinson ◽

Julia V Marley

Keyword(s):

Mental Health ◽

Health Care ◽

Western Australia ◽

Perinatal Depression ◽

Perinatal Period ◽

Screening Tools ◽

Depression And Anxiety ◽

Aboriginal Women ◽

Anxiety Screening ◽

Mood Scale

Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.

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Impact of Jointly Using an e–Mental Health Resource (Self-Management And Recovery Technology) on Interactions Between Service Users Experiencing Severe Mental Illness and Community Mental Health Workers: Grounded Theory Study

JMIR Mental Health ◽

10.2196/25998 ◽

2021 ◽

Vol 8 (6) ◽

pp. e25998

Author(s):

Anne Williams ◽

Ellie Fossey ◽

John Farhall ◽

Fiona Foley ◽

Neil Thomas

Keyword(s):

Mental Health ◽

Mental Illness ◽

Grounded Theory ◽

Community Mental Health ◽

Severe Mental Illness ◽

Health Workers ◽

Health Resources ◽

Community Mental Health Services ◽

Discovery Process ◽

Mental Health Resource

Background e–Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e–mental health resources together with their community mental health workers (MHWs) has received little attention. Objective This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective. Methods We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study’s credibility. Results A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs’ experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building—their interactions when using the website together were more engaging and equal. Conclusions Jointly using an e–mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e–mental health in community mental health practice is warranted.

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Higher levels of autistic traits associated with lower levels of self-efficacy and wellbeing for performing arts professionals

PLoS ONE ◽

10.1371/journal.pone.0246423 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246423

Author(s):

Eleanor Buckley ◽

Elizabeth Pellicano ◽

Anna Remington

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Self Efficacy ◽

Performing Arts ◽

Online Survey ◽

Autistic Traits ◽

Autistic People ◽

First Time ◽

The Relationship

This study sought for the first time to identify the extent to which autistic people are pursuing careers in the performing arts, and to determine the nature of the relationship between individuals’ autistic traits and their reported wellbeing. To address these aims, we recruited a self-selecting, community-based sample of individuals working in the performing arts and invited them to complete an online survey. A total of 1,427 respondents took part. We collected responses on participants’ backgrounds, including diagnostic history as well as measures assessing their level of autistic traits, perceived occupational self-efficacy, quality of life, and mental health. They were also asked open-ended questions about support needed, received, or desired in their workplace. Eleven of the 1,427 professionals (1%) reported a clinical diagnosis of autism. Correlational analyses demonstrated that higher levels of autistic traits were significantly associated with lower levels of quality of life, lower levels of occupational self-efficacy and greater severity of mental health conditions. Almost half the sample of professionals (N = 621; 44%) reported a desire for more employment-based support, and autistic traits were significantly higher in those participants who wanted greater support. Within the community of those working in the performing arts, there are a minority of individuals who are autistic or who have high levels of autistic traits. We have demonstrated for the first time that these individuals may be especially vulnerable to lower wellbeing.

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Impact of COVID-19 on Mental Health: A Longitudinal Study Using Penalized Logistic Regression

10.1101/2021.02.21.21252159 ◽

2021 ◽

Author(s):

Jingyu Cui ◽

Jingwei Lu ◽

Yijia Weng ◽

Grace Y. Yi ◽

Wenqing He

Keyword(s):

Mental Health ◽

Risk Factors ◽

Logistic Regression ◽

Large Scale ◽

Online Survey ◽

Missing Values ◽

Healthcare Providers ◽

Public Mental Health ◽

The Public ◽

Health Related

AbstractThe COVID-19 pandemic has posed significant influence on the public mental health in a stealthy manner. Current efforts focus on alleviating the impacts of the disease on public health and economy, with the psychological effects due to COVID-19 largely ignored. In this paper, we analyze a mental health related dataset from the US to enhance our understanding of human reactions to the pandemic. We are particularly interested in providing quantitative characterization of the pandemic impact on the public mental health, on top of qualitative explorations. We employ the multiple imputation by chained equations (MICE) method to deal with missing values and take the logistic regression with least absolute shrinkage and selection operator (Lasso) method to identify risk factors for mental health. The analyses are conducted to a large scale of online survey data from 12 consecutive weeks, so that the longitudinal trend of the risk factors can be investigated. Our analysis results unveil evidence-based findings to identify the groups who are psychologically vulnerable to COVID-19. This study is useful to assist healthcare providers and policy makers to take steps for mitigating the pandemic effects on public mental health.

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